07110126 CITY O.F CUPERTINO �
BUILD[;tG DIVIS'rJN PERMIT �!�����������������
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PERMIT NO.
BUILDINGADDRESS: FAST WAI'ER HEATER 07110126
10402 NOEL AVE '
PERMIT LS6UE DATE
vWNER'S NAME:
SOMAYAJULU ARYASOMAYAJULA 12601 132 AVE NE � 11/21/2007
SANITARY NO. CON'IROL NO.
PHONE:
(800) 454-8955
BUILDING PERMTI' INFO
ARCHITECIYENGiNEER: HLp(', ELEC7' PLUMB MECH
� � � �
a p�p LICENSED CONTRACI'OR oEC�nxnnoN Job Description
u� ��yy a((� �hat I sm liccnscd undcr provisions af CAaptcr 9(commcncing
� z, � with Section 7000) o(Division 3 of ihc Busincss and Protcssions Codc, and my liccnsc is REMOVE / RE PLAC E GA S WATER HEATER
�� y in full farce and cffa
� � � Licensc CI i �- ContracWr
± F o �atc TF✓'
� A CHI7ECI"S DECLARA770N
��< I undcrstand my plans shill be uud u puhlic records
�yU
� 0 y Liccnsed Prufessional
pWNER-BUILDER DECLARA'CION
,'� i� 1 hcrcby alTirm �hat 1 am racempt Cmm ihe Coniractor's Liccnx Law for the
L p O following rcason. (Scction 7031.5, Busincss and Pmfccsions Cot1c: Any city or wunty
�,°, Pi which requiccs a pcmiit to construct, altct. improve, dcmalish, or icpnir any suucturc
prior u� iL� issuance, alsa requires ihe applicam for such permit io file a signed sta�ment Ft. Floor Area Valuation
��< that he is liccnscd pursuanl to the provisions o[ thc ContracWr's Liccnse Gw (CMap�cr 9 S4• $ 4 4 9
x t T -� �(commencing wi�h Scction 7000) of Division 3 of ihc Busincss and Profcssions Codc) ur
y�� that he ia exempt themfrom and �he basis [or the sllcgcd exemption. My violauon of Occupancy Type
Section 7031.5 by arry applicant [or a permit subjecu the appiicant to s civil penalty of 3 2 6 4 7 0 �� 0�� Number
not more than five hund�ed dollars (5500)•
❑ I. u owrcr o[ ttie property. or my employces wiN wages u their solc compensadon,
will do the work and ihe stcucw�e is not imm�dcd or ottered tor sale (Sec. �oa4. Business Required Inspections
and Professiona Code:'Itm Convutar's License Law does not spply iu an owner uf
property who builds or impcoves thereon, and who does such work himself ar �hrough his
rn+m empbyces, provided that sucA improvemrnu ue not imm�ded or otfercd for sale. l!.
hawever, the building or improvement is sold within one yesr of compleuan, the owner-
builder will have the burden of proving �at he did not build or improvc tot purpoae of
sakJ. .
❑ I, u owner of �he propeny, am aeclusively conuuting with licenaed conuactors a
constnut Uie project (Sec. 7044. Business and Pro[essions Code:) The Contracwrs Li-
cense Law docs ool apply w an owmer of propeny who builds or improves Ihe�eon, and ,
who convacis for such projecls wiU� a conlractor(s) Gcensed pursuant m �he Contrx[or's
'^ense Law.
I am exempt undu Sec. , B& P C far ihis reason
Owner Dale
WORKER'S COMPENSATtON DECLARA770N
1 hercby s(Grm under penalry o[ perjury one o[ the (ollowing dcelsra�ions:
❑ I h=+e and will mainlsin a Cenificate of Consent to self-insurc for Workcrs Compen-
sarion, as providcd for by Section 3700 of the labor Code. far the perfarma�m o[ thc
work for which Ihis permit is issued.
❑ I havc and will m�intain Workcls Compensauon Insurance, u mquired by Scction ,
3700 oC the Labor Code, Car �he perfarmance o( ihe work for which this permi� is issued.
My Warker Compensauon Insunncc cam and Poliry number a�c:
n
Grtier. Policy No.:
, CER77F'[C PCION FROM ORKER ' .
COMPENSATION INSURANCfi
(Ihis section �cd noc bc compieted if t6e pennit is for anc hundred dollars (S 100) ,
or Icss.)
I cenify �hat in thc performa�rcc of �hc work fw which �his permit is issucd, ! shall not
rmploy any person in any manncr so as to bccome wbject w ihe V✓orkcrs' Compensation
Laws of Califomia Datc
Applicam
NOTICE T'O APPLICANf: [f, aMr making �his CcniGcate of F�ccmption, yau should
become subject to �he Worlcer's Compeasation provisions of the Latwr Code, you muu
, ,� fonhwi�h comply with such provisions or this pecmit sha116e dcemed �evoked.
z O CONSTRUCf10N LENDING AGENCY
F r � I hcrcpy aCfirtn dut thcre is a constcucGon Icnding agcncy (or thc per[ortnance of
�� ihe work for which this permit is issued (Scc. 3097. Civ. C.) ,
W Q Lendcr's Namc
� z Lcnde�s Addmss
V � I ceRi[y ihat 1 have read this application and sia�c �hat ihc a6ovc informauun is
w � cortcct. I agrce w comply with all city and counry onlinances and sute Iaws celadng to
0 U building consuuction, and hereby sutharia representativcs of ihis city to cntcr upon the
� W alwve-mcnGoncd propcny (or inspcaion purposes
a (Vyo) agree to save. indcmnify and keep humlest ihe City of Cupertino against
F ,E"�� � liabiliues, judgmcn�s, costs and expensca which may in any way accruc �gainst said Ciry
V z in consequencc ot me granting o[ ihis permit. Dgte �— ��/�
� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT ISSl1Cd b� : I
SOUR GULA770NS.
- Re-roofs ��'�
s� n�, o��a� D i 1 C T of ltoof
HAZARDOUS MATERIALS DISCLOSURE YPe
Will thc applicant or futurc building accupant storc or handlc ha•rardous malcrial
.fefined by Ihe Cupenino Municipal Codc. Chap�cr 9.12. and the Health and Salety
_� Scction 25532(a)? All roofs shall be inspeeted prior to any roofing material being installed.
❑ Ycs �o
Will ihc applicant or futurc building occupant usc cqujpmcnt or Jcvices which
If a roof is installed without first obtaining an inspection, I agree to remove
emi� harardous air coniaminan�s as dc(ncd by the Bay Area Air Quality Managcmen� all new r Zaterials for inspection.
Disuict? 1
� Ycs /g� No
.�
I havc read �he hvardrnu ma�crials requiremcnu undcr Chap�cr 6.95 of ihc Califor-
nia Flcal�h & Safcry Code, Sccuau 25505.25533 and 25534.1 undcrs�and �hat iCthe building ��� r�� �
docs not curtcn�y havc a mnan4 �at it is my responsibiliry w notify �he occupant nf thc
rey�srem whic6 musl be met prior W issuancc oCa Cenificatc of Occupancy. ' $Ii]r1 : of Applieant Date
'- All roof coverings to be Class "B" ar better
r aulhamcd agcn� Datc
From: 10/25/2�7 13:10 �006 P.00.5I005
� 382803
CITY OF CiIFERTIl�O '
WATER F[EATER
CUPER�TINO PERMIT APPLI(:ATION FORM �� � 2
APN # ��
'70�a.G�'J / �a/ o�
Building Address:
'! 0402 NDEL AVE
Owner's Name: �O� #
ARYASOMAYA.lU SOMAYAJULU 408 257-7640
Contractor. p�O� #
FAST WATER HEATER COMPANY 800-454-8955
Cupertino Business Lioease # State License #
29900 877489
Building Permit Info: �
Bld filect la m ��
Tob Dcscripdon:
Remove/Replace Gas Water Heate�
Residentiai $] Commercial ❑
Cost of ProjGCt;
449.00 �
Strapped On �Platform Bonded
New Location � lacr.ment �
QtY. if
A licable Fee ID Fee Des ' tion Fee C�
� PRWHEATR Res:idential Water Heater /Vent BUILDINC�
pC�p� Caaune,r�ial Water Heat+erNent BiJII�3NC
1 PpERNiTTFEE Plwnbing Permit Issuaace PLUMBIl�IG
1 TRA.VDOC Tra re18t Doc�mentation Fce BUII.DING
BUSLIC �3us iness License BUII..IDNG
5 � S /C ��
CITY OF CUPERTINO
4 ITEMS OF 24 pERMI�, RECEIPT OPER.ATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Bl_c: Lot:
APN ......... 32�i47050.00
DATE ISSUED.......: 11�21/2007
RECEIPT #.........: BS)00003298
REFERENCE ID # ...: 07110126
SITE ADDRESS .....: 10�02 NOEL AVE
SUBDIVISION .......
CITY .............. CUPERTINO
IMPACT AREA .......
OWNER ............: SO�IAYAJULU ARYASOMAYAJULA
ADDRESS ..........: 10402 NOEL AVE
CITY/STATE/ZIP ...: LOS ALTOS HILLS CA, CA 94022-3310
RECEIVED FROM ....: FAST WATER HEATER C
CONTRACTOR .......: JEFF JORDAN LIC # 29100
COMPANY ..........: FAST WATER HEATER
ADDRESS ........... 12601 132 AVE NE
CITY/STATE/ZIP ...: KIRKLAND, WA 98034
TELEPHONE ........: (800) 454
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ---------- ---------
BSEISMICRE VALUATION 449.00 0.50 0.00 0.50 0.00
PPERMITFEE FLAT RATE 1.00 40.79 0.00 40.79 0.00
PRWHEATR UNITS 1.00 24.48 0.00 24.48 0.00
TR.AVDOC FLAT R.ATE 1.00 40.79 0.00 40.79 _____0_00
---------- ---------- ---------- -
TOTAL PERMIT : 106.56 0.00 106.56 0.00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
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518 WATER HEATER